Quality in primary care
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This is the fourth in a series of articles about the science of quality improvement. We examine what to measure, how to measure and some important measurement techniques, such as run charts, control charts and funnel plots. These help us to understand healthcare processes, to assess whether they are stable or improving and to determine how they can be improved further.
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Quality in primary care · Jan 2013
Improving the management of obesity in adults: a pilot of a method to identify important barriers to change and tailor interventions to address them.
A tailored approach to implementation can facilitate the routine use of best evidence, and so improve the quality of care delivered. Tailored implementation involves investigating the context and barriers to change before selecting appropriate interventions. However, there is little evidence on the methods of tailoring. This study investigated the tailoring undertaken by two implementation groups as part of a study to improve adherence to NICE guidelines on adult obesity in primary care. ⋯ The facilitated implementation groups method succeeded in identifying appropriate and similar barriers, enablers and implementation interventions, which suggests some justification for this approach to tailoring. However, further research into methods of tailoring is required. Improvements to the implementation group approach may be realised by careful selection of group members and provision of sufficient preparation time prior to group discussions.
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Quality in primary care · Jan 2013
Are patients' preferences for shifting services from medical specialists to general practitioners related to the type of medical intervention?
To improve the feasibility of shifting medical specialist to general practitioner (GP) services in patient-centred health care systems, it is important to know how this substitution is valued by patients. However, insight into patients' preferences is lacking. ⋯ This study provides strong indications that patients' preferences for substitution are influenced by the type of medical intervention. Therefore it seems important that health policy makers, purchasers and practitioners take the preferences of (potential) patients into account.